Diseases of the internal genital organs can lead to the development of rather dangerous conditions for the fetus during its intrauterine development. Inflammatory processes that occur on the cervix are common causes leading to the development of bleeding in the first half of pregnancy.
What it is?
Doctors note that cervical erosion is a fairly frequently recorded pathology that occurs among women. This condition can develop in both a woman who has given birth and a woman who has not given birth.
Experts call cervical erosion damage to the integrity of the mucous membranes in the cervical canal.
The erosion only increases the importance of passing regular examinations by a gynecologist: the danger of this pathology is that it leads to vulnerability to various infections.
Women living in large industrial cities and in areas with unfavorable environmental conditions, according to statistics, have a higher chance of its presence.
According to studies, doctors show signs of cervical erosion in almost every woman during her life.
It is a more vulnerable surface than the rest of the mucosa. Any infectious agent (virus, bacteria) entering the vagina can easily injure it.
For unclear conditions of the cervix a gynecologist may recommend special tests for a woman, the most important of which are:
- colposcopy;
- PAP test (smear analysis for abnormal cells).
Doctors consider pathological erosion to replace the normal epithelial lining of the cervix with a columnar epithelium. The development of this pathological transition is influenced by the most numerous factors. Many of them act on the female body for quite some time.
However, there are often situations when doctors first identify signs of erosion during pregnancy. In this case, all unfavorable symptoms are enhanced by an altered hormonal background, which is associated with an increased concentration of many hormones.
According to statistics, erosion is more often detected in young girls who have not yet celebrated their 25th birthday, which is due to the fact that this condition is not a disease or a defect, but physiological displacement of the intra-cervical epithelium to the surface of the cervix. In this case, there is no need to treat erosion.
Why presence of erosion as the presence of normal columnar intra-cervical epithelium on the surface is normal and why she has nothing to do with cervical cancer or myoma, she will tell in the next program of the program "Living is healthy!" obstetrician-gynecologist, WHO expert, professor and doctor of medical sciences Rogovskaya Svetlana Ivanovna.
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Erosion can develop at any age. Gynecologists note that this pathology is recorded for the first time even in women over 40 years old.
Experts say that the erosive process should not always be treated, but if necessary, the treatment is rather complicated, has many complications (for example, stenosis of the cervical canal and the occurrence of problems with subsequent pregnancy are possible) and requires a mandatory time for rehabilitation - at least 3-4 months. For some women, it may take about six months for full recovery.
That is why, before agreeing to cauterization of erosion, it is worth passing all the necessary tests (colposcopy and PAP test).
During a gynecological examination, doctors identify red spots that are located on the inner lining of the uterus. The process can be single or multiple. The sizes of the formations also vary. Massive processes, as a rule, are accompanied by the appearance of rather pronounced adverse symptoms.
The erosive area of the mucous membrane is quite vulnerable. Pathogenic microorganisms easily penetrate into such a damaged area. This leads to the development of a local and then systemic inflammatory process. The most dangerous is penetration into places of erosion of microorganisms that are sexually transmitted.
The risk of contracting HIV and parenteral hepatitis in women with the acute form of the disease is very high.
Causes of occurrence
To date, scientists have not established a single reason for the development of this condition. Every year, researchers propose new theories of the development of erosion in the cervical canal to the medical community. However, they have not yet succeeded in establishing a single cause of the development of this disease.
Experts believe that the following reasons contribute to the development of this pathological form.
- Too early onset of sexual activity - earlier than 20 years. Scientists believe that at an early age, the epithelial lining of the cervical canal is not yet fully formed. This leads to the fact that during intercourse it is damaged, which further leads to the development of erosion on the cervix.
- Depleted immunity... Women suffering from severe diseases of internal organs or having oncological pathologies are at risk of developing erosion on the cervix. The reduced work of the immune system simply cannot cope with infections that can cause local inflammation on the mucous membranes of the genital organs.
- Dyshormonal disorders. Such conditions, as a rule, are secondary and arise due to various pathologies. Search for the cause of their appearance should be throughout the body. Diseases of the pituitary gland, ovaries, thyroid gland, and other endocrine organs can lead to the development of an imbalance in female sex hormones.
- Delayed treatment of infectionssexually transmitted diseases. Pathogenic microbes, getting on the inner membranes of the uterine cavity, quickly lead to the development of inflammation. Unprotected intercourse and neglect of hygiene procedures contribute to the development of erosion on the cervix in women.
There are other possible reasons as well.
- Long-term use of hormonal oral contraception. Especially often this situation develops if the medicines to protect against unwanted pregnancy were selected incorrectly. In this case, an imbalance of the genitals is formed in a woman, which contributes to the development of erosion in her.
- Previous abortions or spontaneous miscarriages. In this case, the effect on the neck is complex. Detachable areas of the ovum and hormonal disorders contribute to the appearance of erosion. Doctors point out that even one abortion is sometimes enough for the development of the erosive process.
- Frequent change of sexual partners. The development of erosion on the cervix in this case occurs due to trauma to the mucous membranes. Too intense sexual intercourse can also lead to erosion in a woman.
- HPV. Every day, more and more scientific studies are published, suggesting that human papillomavirus infection can lead to the development of erosion on the cervix in women. Scientists have identified several oncogenic subtypes of the human papillomavirus, which can lead to the development of various pathological conditions on the mucous membranes of the genital tract.
- Heredity. If doctors diagnosed cervical erosion in the mother, grandmother or sister of a pregnant woman, then the risk of developing the same pathology increases by 1.5-2 times. This form of the disease is often congenital.
Symptoms
Numerous reviews of women who had erosion during pregnancy indicate that they did not feel any uncomfortable signs of this pathology. They also lacked soreness in the lower abdomen.
However, such a "silent" course of cervical erosion is not always the case. Some women do develop symptoms. Their severity is largely determined by the amount of damaged tissue.
If there are many areas of erosion or they are large, then the symptoms appear much brighter and bring the patient severe discomfort.
Many women brown discharge appears... Most often, they are released from the vagina after intercourse. Also, such discharge may appear after a hot bath or sports. Lifting weights can provoke the appearance of this symptom in a woman.
Usually, discharge during the acute period of this pathology is dark scarlet or brown. If erosion is actively bleeding, then they can acquire a red color. This symptom is extremely unfavorable. Its appearance is a significant reason for an immediate visit to your doctor.
During bleeding from erosion, the woman may experience discomfort or "Pulling" pain in the lower abdomen. This symptom can also be triggered by intercourse, physical activity, or lifting weights. Moderation of the pain symptom is usually insignificant. It usually lasts several hours. The pain can come and go.
Erosion is rarely manifested by any disorders of general well-being. The expectant mother practically does not feel changes in mood or other adverse symptoms associated with this pathology. In some cases, women can only get tired faster and feel very sleepy.
Such manifestations are associated with anemization of the body due to regular blood loss.
Consequences for the fetus
Active erosion of the cervix can be dangerous for both the mother and her baby. During bleeding, blood is released from the damaged area. If this process is regular, then it can contribute to the pronounced anemization of a pregnant woman.
In this case, in her blood the concentration of hemoglobin is significantly reduced, which is necessary for the full growth and development of the fetus. Dissolved oxygen is transferred to the baby's body through hemoglobin.
Anemia caused by frequent bleeding from erosion has a detrimental effect on the intrauterine development of the baby as a whole. Usually, a woman's anemization is moderately expressed, and hemoglobin does not fall below 90 g / liter. More severe conditions require complex treatment.
High risk of infection in "bare" eroded areas can provoke the development of many infections in the fetus. Some of the diseases can even cause abnormalities and malformations of internal organs.
It is especially unfavorable if erosion manifests itself in early pregnancy during the organogenesis of the fetus.
Eroded areas of the uterine mucosa lose their normal density. They can tear easily even when exposed to light to moderate intensity. This situation is possible when a large fetus passes through the maternal genital tract during childbirth. Women with a narrow cervical canal are at a higher risk of developing such ruptures. In this case, doctors try to avoid natural childbirth and use a cesarean section.
The presence of active erosion on the cervix can even lead to the onset of a woman's premature birth. Some pregnant women have cases of early discharge of amniotic fluid. This situation is extremely dangerous for the fetus and requires urgent delivery.
Diagnostics
Unfortunately, it is impossible to determine erosion using only any analyzes. Such tests are only used to establish a possible cause that contributed to the development of this condition.
A diagnosis of cervical erosion is established during extended gynecological examination. If the doctor, during such a study, found any red spots on the mucous membrane of the cervical canal, then he will offer the woman to conduct a colposcopy.
This research method is more accurate. To carry it out, a special device called a colposcope is used. With the help of the device, you can get an enlarged image, which helps the doctor to qualitatively examine all parts of the cervical canal and identify pathologies.
During this study, you can also take several areas of damaged tissue for biopsy. This study will show the morphological picture of the existing changes.
It is after the biopsy that the correct diagnosis can be made. Also, this study is necessary to exclude the transition of erosion to precancerous states.
A biopsy is performed in a special laboratory. The term for this study can be several days. With a busy laboratory, the duration of the test may be a week or more.
If an erosive process is detected on the cervix, the doctor will definitely recommend that the woman take a set of tests for sexually transmitted infections. Such studies necessarily include tests for the detection of chlamydia, gonococcus, treponema pale, herpes viruses, various subtypes of papillomaviruses, HIV.
During an extended gynecological examination a smear is necessarily taken. It serves as specific cell diagnostics. With the help of such a study, atypical cells can be detected, which are markers of the development of neoplasms.
In this case, extended diagnostics will be carried out and a complex of treatment will be prescribed.
Treatment
Does it always need to be treated?
Erosion therapy is not required if it is physiological, that is, it appeared as a result of the development of the mucous membrane.
With age, the body will close this vulnerable area with a more complete protective squamous epithelium, which will gradually gather to the center of the cervical canal and go inside (this process begins to occur in almost all women after 30 years).
With the development of pathology, there are different methods of therapy, many of which have many complications, so they should be decided in exceptional cases when treatment is really necessary.
Cauterization with radio waves
One of the most popular methods is cauterization of the erosive area with radio waves. Sometimes it is held for girls who do not yet have babies.
The method is used in case of chronic recurrent inflammation. Quite often, a scar remains on the neck after such cauterization. This area of tissue is practically not stretched.
During natural childbirth and during the passage of the baby through the birth canal, such a pathology can become a significant threat to normal delivery. It is for this reason that doctors are trying to reduce the possibility of using radio waves to cauterize erosion during pregnancy.
Electricity
Several years ago, gynecologists used treatment with electric current. This technique is very aggressive and traumatic. It quite often leads to the development of scars and scars on the cervix, which are large in size. Such treatment is currently being carried out less and less, as new modern techniques have appeared.
Nitrogen
Another method used by specialists to cauterize erosion is called nitrogen therapy. In this case, the damaged area is treated with liquid nitrogen. With the correct execution technique, the risk of scarring on the cervix is negligible.
Laser
Many gynecologists prefer an alternative therapy that involves the use of laser techniques... This technique is less aggressive and less likely to cause scarring and scarring on the treated neck. Specialists resort to the use of such treatment only in the exceptional case when the pathological process is significantly pronounced.
It is undesirable to treat erosion during pregnancy. Such therapy is carried out only for strict medical reasons.
Other methods
Many doctors try to avoid cauterization of erosion. In this case, they prescribe to expectant mothers drugs that have an effect on the cause that led to the development of this pathology in them. Successfully used in treatment restorative therapy, which is aimed at enhancing immunity.
In medical practice, cases are often recorded when cervical erosion passes on its own after childbirth. This situation is understandable if the erosion was of a physiological origin. Also, its development is possible if hormonal disorders have led to damage to the mucous membrane. After pregnancy, the levels of hormones in the blood of a woman normalize, which leads to epithelialization of damaged tissue.
Many mothers are interested in when they can plan their next pregnancy after cauterization of erosion. Doctors recommend doing this 10-12 months after the moxibustion of the affected area. This period is necessary for the body for full rehabilitation and recovery.
Recommendations
Since the area of erosion is vulnerable, it is necessary to follow the rules of personal hygiene and wash properly, do not allow E. coli to enter the vagina.
During intercourse, it is worth using protective equipment (condoms, spermicides).
